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How to Effectively Manage Asthma

Asthma causes wheezing, shortness of breath, and chest tightness. It also causes coughing, which may be worse at night. If you or a loved one has asthma, find out about the source of this condition and how to effectively manage your symptoms.

Asthma 101

The breathing tubes, or airways, of asthmatics are chronically inflamed. Muscles surround the airways, and when the airways react to something, they swell and cause the muscles around them to contract in response.  As a result, less air flows into the lungs. If more mucous production occurs, as a result of the inflammation, this only adds to the problem. The breathing difficulty of a severe asthmatic worsens with this cycle, and usually worsens quickly, unless you use a rescue inhaler. Because untreated asthma can result in complete airway obstruction, it is important to seek help if you think you might be asthmatic, or if you know you are asthmatic and you have increased and uncontrollable symptoms.

Asthma Quick Facts

• Asthma often runs in families.

• It is also known as reactive airway disease, because the symptoms of asthma are produced by constriction of the airways in reaction to something external.

• In people with mild asthma, the symptoms of asthma may be self-limited.

• Allergies and asthma often occur together.

• Some lifestyle modifications help asthmatics.

• Cockroach droppings are thought to be responsible for the asthma experienced by many children in inner cities.

• Acid reflux causes some people’s airways to constrict.

• Most experts recommend low intensity exercise for asthmatics.

• Omega-3 fatty acids, as in fish oil or flaxseed oil, decrease inflammation and help with asthma.

Current Medications for Asthma


Asthma medications include a class of medications known as beta-agonists, because they affect the beta-receptors in the airway muscle and cause it to relax. A typical asthmatic utilizes a beta-receptor agonist, like an albuterol inhaler, as often as four times a day. When your asthma worsens despite additional inhalations of albuterol, you should go to an emergency department for treatment with steroids to stop the inflammation. Also you need a nebulizer to more effectively administer a beta-agonist. Other medications commonly used by asthmatics include inhaled steroids, which prevent inflammation. Inhaled steroids are not "rescue" inhalers, but have an effect over time of decreasing asthmatic exacerbations.

Asthma Triggers

Pollens or dust mites trigger allergy-induced asthma. If you have both allergies and asthma, you should avoid house pets or certain foods. When the body senses something foreign, it triggers a release of histamines and leukotrienes, which cause the symptoms of runny nose and congestion. These same chemical triggers can cause the initial irritation of the airway. A medication that modifies leukotrienes prevents and controls the release of other immune system reagants during an asthma attack. Allergy shots also help combat this problem.

Some allergic triggers to asthma include tobacco smoke, dust mites, industrial pollution, and roach droppings. Other asthma triggers are mold, wood smoke, cockroach dropping or infection. Although short-term medication - like albuterol - may help treat an acute asthma attack, you should realize that long-term medications prevent such attacks.

Allergic Reactions

An allergic reaction typically occurs during the second time your body encounters a substance that it has perceived as foreign or dangerous. The body makes antibodies known as IgE antibodies, in reaction to something the body first experiences as an allergen. These antibodies release the next time your body encounters the allergen, and they cause your immune system to release histamines and other chemicals. By interfering with the IgE in the body, some medications work to prevent the release of these endogenous substances.

Things Asthmatics Should Avoid

Because of the allergic component, you should reduce the amount of foods you consume which have additives or are cooked with hydrogenated and partially hydrogenated oils. Nitrates and nitrites, as in deli meat and cheese, hot dogs, and bacon all contain sulfites, and you should steer clear of these. B 12 supplements help asthmatics, along with molybdenum, to metabolize sulfites (deCassia et al., 2013).


Exercise should include a balance of aerobic and resistance training, with stretching for 10 minutes, but doctors advise that you do low intensity activities and avoid strenuous activity. Antioxidant therapy is important if you have asthma, and you get antioxidants through either diet or supplements. Magnesium relaxes smooth muscle, and increasing the amount of magnesium in your diet or by supplements, aids in the prevention of the muscle constriction that causes the airways to narrow (deCassia et al., 2013).

Bitter Compound Could Help Scientists Treat Asthma

Several years ago, researchers found taste receptors in the cells of study participants’ intestines. Recent research at the University of Massachusetts Medical School identified taste receptors in the airway, and linked them to a reaction with bitter substances, like quinine. Quinine and other bitter compounds cause the airway muscles to relax. These scientists utilized a substance known as the bitterest compound in existence, called denatonium, and studied its reaction on the taste receptors in the airway cells of mice (Johnson, 2013).

The results of the study were counter-intuitive. However, Rongus ZhuGe, a microbiologist at the University previously read of experiments that suggested bitter compounds caused some smooth muscle cells to relax.  In addition to implications for asthma control, smooth muscle also surrounds the blood vessels, and this knowledge could help researchers and scientists develop new medications for blood pressure and asthma control (Zhang et. al., 2013).

Rongus ZhuGe studied cell signaling in muscle function, and discovered the precise cellular mechanisms were at play. He is not, however, sure of the evolutionary processes which led to taste receptors in the airways. He speculates that it might be a protective mechanism, as part of the fight-or-flight response the body preserves to protect itself when confronted with a real or perceived threat. ZhuGe published the results of his study in PLOS Biology in early March of this year (Zhang et. al., 2013).

Summary

With exciting new treatment options on the horizon, you should remember that asthma attacks, or exacerbations, have caused many deaths. Parents of small children need to understand that it is difficult to definitively diagnose asthma before the age of 5. However, many children are treated presumptively if they experience symptoms that they may someday outgrow. With the availability of long-term preventive maintenance therapies, most people should be able to live with asthma without significant disruption in their lives. Failure to control asthma long-term can result in serious and life-threatening problems. At the same time, those who suffer with asthma will be happy to hear of this potential breakthrough.

References

de Cássia Ribeiro Silva R, Assis AM, CruzAA et al. Dietary Patterns and Wheezing in the Midst of Nutritional Transition: A Study in Brazil. Pediatr Allergy Immunol Pulmonol. 2013 Mar;26(1):18-24.

Johnson, C.Y. of Boston.com (2013). Could a bitter compound provide clues about how to treat asthma?

Zhang T, Smith MA, Camp PG, Carleton BC. High use of health services in patients with suboptimal asthma drug regimens: a population-based assessment in British Columbia.  Pharmacoepidemiol Drug Saf. 2013 Apr 5 in print.

Zhang CH, Lifshitz LM, Uy KF, Ikebe M, Fogarty KE, Zhuge R. The cellular and molecular basis of bitter taste ant-induced bronchodilation. PLoS Biol. 2013 Mar;11(3):e1001501. doi: 10.1371/journal.pbio.1001501.

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